Safer Food Choices for People With Weakened Immune Systems

May 2, 2024

People with weakened immune systems are more likely to get sick from certain germs spread through food, like Listeria.
Some foods are more likely to spread harmful germs, including undercooked meat and eggs, unpasteurized milk and cheese, and unwashed produce.
If you have a weakened immune system, choose safer food options to protect yourself from food poisoning.
In addition to avoiding riskier foods, always follow the four steps to prevent food poisoning: clean, separate, cook, and chill.

Two immunocompromised people - one on dialysis and one with glucose monitor for diabetes

Why it's important

People with weakened immune systems have a higher risk of food poisoning. That's because a weakened immune system may make it more difficult for your body to fight germs and sickness effectively.

You may have a weakened immune system if you have diabetes, liver disease, kidney disease, alcoholism, HIV, an autoimmune disorder (such as lupus), or are receiving chemotherapy or radiation therapy.

To prevent food poisoning, some foods are safer choices than others. That's because some foods—such as undercooked meat and eggs, unwashed fruits and vegetables, and unpasteurized milk—are more often associated with foodborne illnesses.

Fact

People on dialysis are 50 times more likely to get a Listeria infection.

Safer food choices

Use the table below as a guide to safer food choices. You should also always follow steps to prevent food poisoning.

Poultry and Meat

Riskier Choice

Safer Choice

Raw or undercooked poultry or meat
- Poultry includes chicken and turkey
- Meat includes beef, pork, lamb, and veal
Unheated deli meat, cold cuts, hot dogs, and fermented or dry sausages
Refrigerated pâté or meat spreads

Poultry and meat cooked to a safe internal temperature. Use a food thermometer to check.
- All poultry, including ground chicken and turkey, cooked to 165°F
- Whole cuts of beef, veal, lamb, and pork cooked to 145°F (then allow the meat to rest for 3 minutes before carving or eating)
- Ground meats, such as beef and pork, cooked to 160°F
Deli meat, cold cuts, hot dogs, and fermented or dry sausages heated to 165°F or until steaming hot
Pâté or meat spreads in sealed, airtight containers that don’t need to be kept refrigerated before opening

Deli salads

Riskier Choice

Safer Choice

Premade deli salads, such as:

- Coleslaw
- Potato salad
- Tuna salad
- Chicken salad
- Egg salad

Homemade deli salads

Vegetables and Fruits

Riskier Choice

Safer Choice

Any raw or undercooked sprouts, such as alfalfa and bean
Unwashed fresh fruits and vegetables, including lettuce and other leafy greens
Cut melon left out for more than 2 hours (1 hour if it’s exposed to temperatures hotter than 90°F, such as a picnic or hot car)

Cooked sprouts
Washed vegetables and fruits (washed and then cooked are safest)
Freshly cut melon or cut melon kept refrigerated for 7 or fewer days

Juice

Riskier Choice

Safer Choice

Unpasteurized juice or cider

Pasteurized juice or cider
Unpasteurized juice or cider brought to a rolling boil for at least 1 minute before drinking

Milk

Riskier Choice

Safer Choice

Unpasteurized (raw) milk and dairy products made from unpasteurized milk

Pasteurized milk and dairy products made from pasteurized milk

Cheese

Riskier Choice

Safer Choice

Soft cheese made from unpasteurized (raw) milk—for example, queso fresco, brie, camembert, and blue-veined cheese
Any queso fresco-type cheese, when made with pasteurized or unpasteurized (raw) milk, such as queso fresco, queso blanco, requesón, or similar fresh, soft cheeses
Unheated cheese sliced at a deli

Hard cheese, when made with pasteurized milk, such as Asiago, Cheddar, Parmesan, or Swiss/Gruyere/Emmental
Cottage cheese, cream cheese, string cheese, feta and mozzarella, when made with pasteurized milk
Pasteurized soft cheeses heated to an internal temperature of 165°F or until steaming hot
Deli-sliced cheeses heated to 165°F or until steaming hot

Eggs

Riskier Choice

Safer Choice

Raw or undercooked (runny) eggs, and foods that contain raw or undercooked eggs, such as

Caesar salad dressing
Raw cookie dough
Eggnog

Eggs cooked until the yolks and whites are firm
Egg dishes (frittata, quiche, casserole) cooked to an internal temperature of 165°F if they contain meat or poultry
Egg dishes cooked to an internal temperature of 160°F if they do not contain meat or poultry
Pasteurized eggs in foods that will not be cooked to a safe temperature, such as mousse and salad dressing

Seafood

Riskier Choice

Safer Choice

Raw or undercooked fish or shellfish, including sashimi, sushi, and ceviche
Refrigerated smoked seafood (except in a cooked dish). Refrigerated smoked seafood is usually labeled as "nova-style," "lox," "kippered," "smoked," or "jerky"

Fish cooked to a safe internal temperature of 145°F or until the flesh is opaque and separates easily with a fork
Shellfish cooked until shells open during cooking or until flesh is pearly or white, and opaque
- After the shells open, boil live oysters for another 3–5 minutes.
Smoked fish in sealed, airtight packages or containers that don’t need to be kept refrigerated before opening
Smoked fish cooked in a casserole or other cooked dishes
Canned fish and seafood

Flour

Riskier Choice

Safer Choice

Raw dough or raw batter made with raw (uncooked) flour

Food made with flour that is cooked following the package directions or recipe
Dough and batter made with heat-treated flour and pasteurized eggs
Dough and batter that is labeled “edible” or “safe to eat raw”

Resources

Current Outbreaks

Current foodborne outbreak investigations and selected outbreak notices.

FoodSafety.gov: Cook to a Safe Minimum Internal Temperature

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Safer Food Choices for People With Weakened Immune Systems

Information on which foods are safer to consume and which are more likely to cause food poisoning fo...

Safer Food Choices for People With Weakened Immune Systems

At a glance

Why it's important

Fact

Safer food choices

Resources

Print handout

Food Safety

For Everyone

Health Care Providers

Public Health